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SLP PRAXIS PREP > CH7: VOICE > Flashcards

CH7: VOICE Flashcards

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1
Q

Ventricular/ false vocal folds do not vibrate during normal phonation and used only during ____?

A

activities such as lifting and coughing

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2
Q

what folds separate the pharynx and laryngeal vestibule?

A

aryepiglottic folds

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3
Q

Primary cranial nerve for laryngeal innervation

A

cranial nerve 10: vagus nerve

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4
Q

This vocal structure is cartilage attached to hyoid bone and covers trachea so that food and drink go to esophagus.

A

EPIGLOTTIS

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5
Q

These laryngeal muscles are responsible for controlling vocalization

A

intrinsic laryngeal muscles: thyroarytenoids, cricothyroids, cricoarytenoids, transverse oblique arytenoids

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6
Q

These laryngeal muscles elevate and lower larynx position

A

Extrinsic Laryngeal Muscles

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7
Q

Mean Fo range for kids 7-8 years old

A

281-297 HZ

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8
Q

Max Phonation Time….what happens from 7 to 15 yrs of age

A

sustaining ah…doubles in time from 7.5 to 15 seconds

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9
Q

MFF for men

A

average is 125 HZ (Range is 100-150)

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10
Q

MFF for women

A

average is 225 Hz with range of 180-250

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11
Q

MPT - max phonation time: adults 18-29

A

21-24 ish seconds

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12
Q

age related changes in larynx include

A

laryngeal cartilage hardening

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13
Q

age related changes of larynx lead to______

A

presbyphonia

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14
Q

presbyphonia

A

age related voice disorder with perceptual changes in quality range loudness and pitch

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15
Q

Perceptual correlate of frequency

A

PITCH

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16
Q

perceptual correlate of intensity

A

LOUDNESS or VOLUME

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17
Q

perceptual correlate of complexity

A

VOICE QUALITY

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18
Q

determined by mass, tension, elasticity of VF’s

A

PITCH

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19
Q

Jitter is _____

A

frequency perturbation- variations in vocal frequency- dysphonic patients

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20
Q

Shimmer is _____

A

amplitude/ loudness perturbation- variation of vocal intensity

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21
Q

A speaker with or without laryngeal pathology will have small variation of intensity per cycle (shimmer is less than 1 dB)

A

WITHOUT LARYNGEAL PATHOLOGY

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22
Q

Types of vocal quality

A

on piece of paper - refer to this! *

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23
Q

Before beginning voice therapy it is necessary to obtain

A

must obtain a medical evaluation of vocal mechanism prior to voice therapy

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24
Q

Indirect laryngoscopy

A

bright light source and small mirror - press against pharyngeal wall area. view during phonation.

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25
Q

Direct Laryngoscopy

A

by surgeon under anesthesia - laryngoscope through mouth into pharynx and above VF’s.

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26
Q

Patient can or can’t phonate during direct laryngoscopy

A

CAN NOT PHONATE DURING THIS PROCEDURE- good for biopsy with laryngeal cancer

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27
Q

Flexible Fiber- Optic Laryngoscopy

A

thin, flexible tube with fiber- optic light bundles. through nasal passage and above larynx

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28
Q

Can the patient sing or phonate during the flexible fiberoptic laryngoscopy?

A

YES! they can sing or phonate during this laryngoscopy.

excellent for rapid VF movement

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29
Q

Endoscopy

A

flexible (nasal) or rigid (orally) - can view VP valving mechanism.

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30
Q

Spectrogram shows ____________

A

the resonant characteristics of the vocal tract and harmonic nature of glottal sound source

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31
Q

videostroboscopy helps to detect ____

A

laryngeal neoplasms (tumors) with either a laryngoscope or endoscope

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32
Q

Stroboscopic image from videostroboscopy gives information on the ___ and _____

A

1) regularity of vocal fold vibration
2) vocal fold amplitude (loudness)
3) glottal closure
4) possible tumors

^^^ given by a ______image

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33
Q

EGG- electroglottography

A

indirect measure of vocal fold closure patterns

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34
Q

recommended as cross validation tool with other measures of vocal fold functioning

A

EGG

35
Q

EMG- electromyography

A

invasive procedure directly measures laryngeal function to study electrical activity of vocal folds

needle electrodes

36
Q

EMG looks at _____

A

vocal fold functioning- muscle activity and activation

37
Q

Videokymography

A

high speed medical imaging

38
Q

Aerodynamic Measurements

A

airflows, air volumes, average air pressures

39
Q

Aerodynamic measurements used to evaluate

A

dysphonia, monitor voice changes, differ between laryngeal and respiratory issues

40
Q

MPT- max phonation time assesses _____

A

sustain “a” during one exhalation: respiration, glottal efficiency, vocal pathology

41
Q

s/z ratio determines if

A

determines if a laryngeal pathology: produce 2 long /s/ sounds and 2 long /z/ sounds .

divide longest s by longest z FOR RATIO

42
Q

s/z ratio more than 1.4 indicates ____

A

possible laryngeal pathology

43
Q

hypernasality results when

A

the VP mechanism doesn’t close nasal passage during non-nasal sounds. ( cleft, adenoidectomy, paralysis of velum due to CP, parkinsons)

44
Q

hypernasality has most affect on 3 manners of artic

A

1) fricatives
2) affricates
3) plosives

most impacted by this vocal quality

45
Q

Etiology of VPI

A

page 288- adenoidectomy, decreased mass of velum

46
Q

hyponasal patients may exhibit the following

A

pts with this vocal quality exhibit

1) open mouth breathing
2) enlarged adenoids

47
Q

frequent hyponasal substitutions

A

b/m, d/n, g/ng

48
Q

nasometer

A

gives visual feedback on computer for oral-nasal ratio - to achieve within normal limits for hypernasal patients

49
Q

to decrease HYPONASALITY in patient

A

1) words with nasal sounds said with exaggeration - feel vibrations in mask
2) nasal glide stimulation: combination helps direct resonance into nasal cavity
3) visual aids - mirror or tissue

50
Q

exaggerating consonants in articulation can alter perception of _______

A

hypernasal resonance - lessen the extra nasal resonance.

51
Q

3 categories for laryngeal cancer

A

T ( site of tumor)
N ( involvement of lymph nodes)
M ( metastasis)

52
Q

stoma

A

opening made in lower part of neck for breathing

53
Q

esophageal voice is produced by ___

A

PES- pharyngoesophageal segment- vibratory source

54
Q

Blom- Singer tracheoesophageal puncture TEP

A

the tracheoesophageal wall ( separates trachea and esophagus) is punctured. device prevents passage of food and liquid into the trachea.

55
Q

granulomas are vascular lesions usually developed on the

A

arytenoid cartilages in posterior laryngeal area

56
Q

Hemangiomas

A

soft pliable filled with blood- similar to granulomas

usually surgically removed

57
Q

Leukoplakia

A

benign white thick patches on mucosa -

sounds low pitched breathy and soft in vocal quality

58
Q

hyperkeratosis

A

rough pink lesion in oral, pharynx or larynx

reduced loudness and low pitch

59
Q

laryngomalacia

A

epiglottis impacted- abnormal development. epiglottis resists the airstream causing stridor ( rough and breathy noise upon inhalation)

60
Q

papillomas

A

primarily in kids and wart like growths by HPV- MANY SURGERIES NEEDED FOR THIS phonation disorder

most concerned about airway preservation

61
Q

young kids can experience laryngeal trauma by

A

intake of sharp object

62
Q

laryngeal web

A

membrane grows in anterior portion of glottis

63
Q

PVFM: paradoxical vocal fold motion disorder

A

aka laryngeal dyskinesia –> inappropriate adduction (closure) of true vocal folds during inhale or exhale.

64
Q

patients with paradoxical vocal fold disorder appear

A

asthmatic - some display stridor and dysphonia

65
Q

ankylosis

A

movement of arytenoids restricted because of bone disease .

66
Q

popular technique for vocal fold medialization

A

thyroplasty type 1 - window in thyroid cartilage and places silastic implant to keep paralyzed fold medialized.

67
Q

spasmodic dysphonia

A

laryngeal dystonia
can be abducted or adducted
botox used a lot with hyperadduction cases

68
Q

MS, MG, ALS, parkinsons

A

page 301

69
Q

ALS patients have poor

A

respiratory control, low pitched monotonous speech

70
Q

vocal nodules

A

increase mass of folds, often bilateral, make the folds vibrate at slower rate and result in lower pitch

71
Q

polyps are unilateral

A

USUALLY!

72
Q

patients with polyps sound

A

breathy and hoarse - diplphonia may be present too.

73
Q

contact ulcers

A

ulcerated granulated tissue on posterior third of glottal margin

74
Q

always ensure____ is completed before voice therapy

A

medical evaluation must be completed

75
Q

pharyngeal focus treatment should use

A

facial mask technique

76
Q

LOW PITCH VOICE

A

typically breathy and hoarse

77
Q

if larynx too elevated and high pitch voice problematic

A

yawn sigh, open mouth, digital manipulation successful to lower pitch

78
Q

Lombard effect

A

patient voice becomes louder in presence of background noise

79
Q

estrogen does not affect vocal folds

A

TRUE

80
Q

techniques for feminine sound voice

A

greater articulatory precision, softer voice, more modals ( may, will, shall, must)

81
Q

tongues more anterior in oral cavity during speech

A

helps achieve forward resonance - characteristic of female voice

82
Q

female to male gender reassignment can achieve lower pitched voice ( less effort in Female to male )

A

through hormonal therapy since the testosterone thickens the VF’s and produces lower pitch.

83
Q

HIGH PITCH

A

thin and tense vocal folds

84
Q

LOW PITCH

A

THICK AND RELAXED VOCAL FOLDS

SLP PRAXIS PREP (3 decks)

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